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Oxford Textbook of Medicine$
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Edited by David A. Warrell, Timothy M. Cox, John D. Firth

Online access to the Oxford Textbook of Medicine in low and middle income countries is available through the World Health Organization-led HINARI Access to Research in Health programme

Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates
include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Lung flukes (paragonimiasis)

Chapter:
Lung flukes (paragonimiasis)
Author(s):

Udomsak Silachamroon,

Sirivan Vanijanonta

DOI:
10.1093/med/9780199204854.003.071103_update_001

Update:

Epidemiology—Paragonimus kellicotti emerging pathogen in the United States of America.

Investigation—Ziehl–Neelsen staining superior to wet smear for detecting ova in sputum.

Updated on 31 May 2012. The previous version of this content can be found here.

Paragonimiasis is an infection by flukes of the genus Paragonimus, with foci of disease in Asia, Africa, and Central and South America. Humans acquire infection by eating metacercariae in improperly cooked freshwater crabs or crayfish. Acute inflammatory and allergic symptoms are rarely serious and usually resolve spontaneously. Chronic manifestations may be (1) pulmonary—most remarkably with a chronic, productive cough with jam-like, brownish-red sputum; and (2) extrapulmonary—most importantly in the central nervous system, often presenting with seizures. Diagnosis is by demonstrating ova in sputum, stool, or pleural fluid. Serology can be used to support the diagnosis, especially in extrapulmonary paragonimiasis. Treatment with praziquantel is almost always effective. Prevention is by health education and the mass treatment of infected people in an endemic area.

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